Nerisa Iolani Soeharto, PA-C in Austin, TX - Medicare Physician Assistant

Nerisa Iolani Soeharto, PA-C is a medicare enrolled "Physician Assistant" in Austin, Texas. Her current practice location is 3110 Guadalupe St Ste 100, Austin, Texas. You can reach out to her office (for appointments etc.) via phone at (512) 675-1359.

Nerisa Iolani Soeharto is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1770360588.

Contact Information

	Nerisa Iolani Soeharto, PA-C
	3110 Guadalupe St Ste 100, Austin, TX 78705-2858
	(512) 675-1359
	Not Available

Map and Direction

Provider's Profile

Full Name	Nerisa Iolani Soeharto
Gender	Female
Speciality	Physician Assistant
Location	3110 Guadalupe St Ste 100, Austin, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770360588
Provider Enumeration Date: 09/14/2023
Last Update Date: 04/09/2024

Medicare PECOS Information:

PECOS PAC ID: 0143678011
Enrollment ID: I20231204000701

Medical Identifiers

Medical identifiers for Nerisa Iolani Soeharto such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770360588	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nerisa Iolani Soeharto is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Nerisa Iolani Soeharto, PA-C 3110 Guadalupe St Ste 100, Austin, TX 78705-2858 Ph: () -	Nerisa Iolani Soeharto, PA-C 3110 Guadalupe St Ste 100, Austin, TX 78705-2858 Ph: (512) 675-1359

Reviews and Comments

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Nerisa Iolani Soeharto, PA-C - Medicare Physician Assistant in Austin, TX